Carrieri Daniele, Dheensa Sandi, Doheny Shane, Clarke Angus J, Turnpenny Peter D, Lucassen Anneke M, Kelly Susan E
Egenis, University of Exeter, Exeter, UK.
Faculty of Medicine, University of Southampton, Southampton, UK.
Eur J Hum Genet. 2017 Oct;25(10):1106-1112. doi: 10.1038/ejhg.2017.122. Epub 2017 Aug 2.
This paper explores the views and expectations of patients concerning recontacting in clinical practice. It is based on 41 semi-structured interviews conducted in the United Kingdom. The sample comprised patients or parents of patients: without a diagnosis; recently offered a test for a condition or carrier risk; with a rare condition; with a variant of unknown significance - some of whom had been recontacted. Participants were recruited both via the National Health Service (NHS) and through online, condition-specific support groups. Most respondents viewed recontacting as desirable, however there were different opinions and expectations about what type of new information should trigger recontacting. An awareness of the potential psychological impact of receiving new information led some to suggest that recontacting should be planned, and tailored to the nature of the new information and the specific situation of patients and families. The lack of clarity about lines of responsibility for recontacting and perceptions of resource constraints in the NHS tended to mitigate respondents' favourable positions towards recontacting and their preferences. Some respondents argued that recontacting could have a preventative value and reduce the cost of healthcare. Others challenged the idea that resources should be used to implement formalised recontacting systems - via arguments that there are 'more pressing' public health priorities, and for the need for healthcare services to offer care to new patients.
本文探讨了患者在临床实践中对再次联系的看法和期望。它基于在英国进行的41次半结构化访谈。样本包括患者或患者的父母:未确诊;最近接受了某种疾病或携带者风险检测;患有罕见疾病;有意义未明的变异——其中一些人已经被再次联系过。参与者通过国民医疗服务体系(NHS)以及特定疾病的在线支持小组招募。大多数受访者认为再次联系是可取的,然而对于何种新信息应引发再次联系,存在不同的意见和期望。意识到接收新信息可能产生的心理影响,一些人建议再次联系应该有计划,并根据新信息的性质以及患者和家庭的具体情况进行调整。NHS中关于再次联系的责任界限不明确以及对资源限制的看法,往往会削弱受访者对再次联系的支持态度及其偏好。一些受访者认为再次联系可能具有预防价值并降低医疗成本。其他人则对将资源用于实施正式的再次联系系统的观点提出质疑——理由是存在“更紧迫”的公共卫生优先事项,以及医疗服务机构需要为新患者提供护理。